Interim Guidance for Responding to COVID-19 Among the Unsheltered Homeless

By Ceylan Karasapan Crow Directly sourced from:

This interim guidance is based on what is currently known about coronavirus disease 2019 (COVID-19). The Centers for Disease Control and Prevention (CDC) will update this interim guidance as needed and as additional information becomes available. This guidance is intended to provide key actions that local and state health departments, homelessness service systems, housing authorities, emergency planners, healthcare facilities, and homeless outreach services can take to protect people experiencing homelessness from the spread of COVID-19.

Background

People experiencing unsheltered homelessness (those sleeping outside or in places not meant for human habitation) are at risk for infection when there is community spread of COVID-19. This interim guidance is intended to support response planning by local and state health departments, homelessness service systems, housing authorities, emergency planners, healthcare facilities, and homeless outreach services. Homeless shelters and other facilities should also refer to the Interim Guidance for Homeless Shelters. Community and faith-based organizations can refer to the.Interim Guidance for Community and Faith-based Organizations for other information related to their staff and organizations.

COVID-19 is caused by a new coronavirus. There is much to learn about the transmissibility, severity, and other features of the disease. Everyone can do their part to help plan, prepare, and respond to this emerging public health threat.

https://www.saysc.org/housing/

Lack of housing contributes to poor health outcomes, and linkage to permanent housing should continue to be a priority. In the context of COVID-19, the risks associated with sleeping outdoors in an encampment setting are different than with staying indoors in a congregate setting such as an emergency shelter or other congregate living facility. Outdoor settings may allow people to increase distance between themselves and others. However, sleeping outdoors often does not provide protection from the environment, quick access to hygiene and sanitation facilities, or connection to healthcare. The balance of risks should be considered for each individual experiencing unsheltered homelessness.

Partnerships

Reaching and protecting people experiencing unsheltered homelessness during the COVID-19 outbreak will require coordination across several local sectors. To prevent negative outcomes from lack of services, community leaders should continue activities that protect people experiencing homelessness, including supporting continuity of homeless services, healthcare, behavioral health services, food pantries, and linkages to permanent housing. Plans need to be clearly communicated to all stakeholders.

Prevention measures

Encampments:

Communications:

Provide straightforward communications to people sleeping outside in the appropriate language. Identify people who are influential in the community who can help communicate with others. Post signs in strategic locations to provide information on hand hygiene, respiratory hygiene, and cough etiquette. Request up-to-date contact information for each person.

Information to share includes:

People at Higher Risk of COVID-19

Some people who are experiencing unsheltered homelessness may be at higher risk of moderate to severe disease because of certain conditions. Pay particular attention to preventing disease among these individuals.

Isolation housing

Local partners should plan for where individuals and families with suspected or confirmed COVID-19 experiencing unsheltered homelessness can safely stay. These should include places where people who are confirmed to be positive and those awaiting test results can be isolated. Additionally, if a person needs to be hospitalized, a plan should be in place for how they will safely recover after discharge. Ideally, these individuals will be housed for the duration necessary, as outlined in the recommendations for discontinuation of isolation. Isolation housing could be units designated by local authorities or shelters determined to have capacity to sufficiently isolate these individuals. If medical care is not necessary and if no other options are available, advise the individual on how to isolate themselves while efforts are underway to provide additional support. In each scenario, identify how to safely transport patients to and from healthcare and housing facilities.

Behavioral health teams should be involved in the planning for these sites to facilitate continued access to support for people with substance abuse or mental health disorders. In some situations, for example due to severe untreated mental illness, an individual may not be able to comply with isolation recommendations. In these cases, community leaders should consult local health authorities to determine alternative options.

Homeless services outreach staff

When COVID-19 is spreading in your community, assign outreach staff who are at higher risk for severe illness to other duties. Advise outreach staff who will be continuing outreach activities on how to protect themselves and their clients from COVID-19 in the course of their normal duties. Instruct staff to: